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EMDI Program Guide v3.7
The goals for the EMDI program are to:
The goal of EMDI is to ‘Reduce Provider Burden’. EMDI program obtains this goal by harmonizing Health IT standards to achieve interoperability and establishing a secure communication between providers to share structured electronic medical documentation.
To achieve this goal, following objectives have been identified:
- Process Perspective:
- Improve medical document sharing
- Automate manual processes
- Improve provider workflow
- Reduce claims re-submission
- Financial Perspective:
- Reduce time
- Reduce cost
- Reduce resources
- Provider Perspective:
- Improved provider-to-provider communication
- Provider’s satisfaction
- Growth Perspective:
- Expansion of EMDI beyond pilot
- Additional use cases for EMDI workflow
To achieve these goals, CMS will:
- Develop and maintain the EMDI Program Guide containing the content specifications and transport specifications needed for EMDI pilots and implementations.
- Identify and fill in the gaps in the current standards to achieve an increased level of interoperability among providers.
- Encourage EMDI participants with others to conduct pilots.
- Demonstrate the utility of standards by establishing pilot programs with existing health information handlers, health information service providers, document transfer vendors, interface vendors, healthcare organizations, and healthcare providers.
- Facilitate the implementation of secure transport of interoperable electronic medical documentation and help overcome barriers faced by organizations during the pilot implementation.
- Define and collect data for measures to determine the success of the pilot program.
Section 1.4: CMS and Other Industry Efforts in Interoperability
Section 1.4.1: HL7 Da Vinci
Section 1.4.2: DME eRx Pilots with EMDI
Section 1.4.3: ONC FHIR at Scale Taskforce (FAST)
Section 1.8.4: FHIR based technologies
Section 4: EMDI Related Programs and Initiatives
Section 4.3: CMS and HL7 Initiatives
Section 4.4: Alternative DME Electronic Order System
Appendix H: EMDI FHIR Implementation Guidance
Global: Renamed EMDI Implementation Guide to EMDI Program Guide.
Global: Removed unnecessary capitalization and acronyms to be consistent.
Global: Verified links and section links.
Global: Removed EMR reference from all sections.
Global: Rearranged sections for improved flow.
Global: Added cross-reference for all sections
Global: Verified acronym naming convention
Global: Restructure the Use Case section for improved flow
Global: Verified all links are valid and accurate
Updated based on direct edits and comments from Melanie Combs-Dyer
|11/03/2016||0.4||Continued updates based on information provided by CMS and software vendors|
|11/10/2016||0.5||Updates based on comments from Hyland and CIOX Health. Updates in general for various TBD items|
Added LOINC codes for documentation requests
|03/03/2017||0.7||Updated the Implementation Guide to an XLC template and address the comments from stakeholders, Included updated data elements and XLM sample code.|
|04/07/2017||1.0||Updated IG with FHIR related content as well refined the content. Made some corrections and formatting changes. Updated Single schema with few elements updated.|
|05/05/2017||1.1||Updated the guide with comments from CMS and data standards SME.|
|05/19/2017||2.0||Combined HHA and DME versions to make a common Implementation Guide for both. Changed the version to be 2.0 as it’s a major change.|
|06/16/2017||2.1||Added Appendix J for FHIR Implementation Guide. Added identified list of resources.|
|07/21/2017||2.2||Added sections regarding Appropriate Use Criteria (AUC), Section 2.1.4., Section 3.1.5, Section 4.2. Appendix L and Appendix N have been updated.|
|08/18/2017||2.3||Update language in assumptions around EMDI requirements that may vary per organization existing system and infrastructure. Changes made in section 3.1.1 and 2.2.2|
|09/18/2017||2.4||Update language in the section 3.1.1 Assumptions to include Compliant and Striving pilots definitions.|
Section for Signatures has been added under Assumptions in Section 3.1.6 and under Pilot Implementation Overview in Section 4.3.
Section 5.4 Contributors has been added to recognize external contributors of IG
Section 5.5 Points of Contact has been moved at the end of Section 5 and has been updated with contacts for eClinical template workgroup. Also, Table 13 has been updated with current EMDI Project Manager and a new resource.
|11/30/2017||2.6||Section 1.3 Additional Considerations has been added to Section 1 Introductions to include a reference to the ONC Interoperability Standards Advisory.|
Section 2.3.3 Structured Formats with details for CCDA and CDP1.
Appendix N: Referenced Documents for CCDA has been added
Appendix L: Acronyms for CCDA and CDP1 has been updated
Section 5.4: Contributors has been updated
Section 2.1.5: DME eOrder System section has been added to specify criterias for DME eOrder system
Section 2.3: Standards and Protocols has been updated
Appenxix G: CMS Suggested Clinical Data Elements
Section 5.5 Points of Contact has been updated to add Vidya Sridhar’s information
Global: Rearrangement of Implementation Guide sections
Global: Improvement for accuracy of information
Global: Removed Pilot Guidance from Implementation Guide. Will be delivered as a separate guide
Global: Removed the Prior Authorization and Pre- Claim section
Section 2: EMDI use cases moved to overview section
Section 2.2: Revised Use case workflow sequence diagrams to capture acknowledgements accurately
Section 2.2.1: Updated the workflow of service delivery in use case 1
Section 2.4: Revised standards and protocols section
Section 4: Updated Assumptions/Constraints/Risk section
Section 5: Grouped Clinical templates, AUC, and DME eOrder System under ‘Other suggested programs and functionality’
Section 5.2: Combined Appropriate use program information in one section
Appendix B: Added Signature data block and removed beneficiary and subscriber data block from metadata elements.
Global: Rearrangement of Implementation Guide sections
Global: Updated language from ‘recommended standards/formats’ to ‘identified standards/formats’
Global: Include Hospice Care as a provider
Global: Remove Laboratory Testing as a provider
Section 1: Updated the Introduction to include the goal of reducing provider burden
Section 1.3: Added language for the Overarching Goals of Promoting Interoperability and the 21st Century Cures Act
Section 2.3: Updated content for Interface vendors and Document Transfer Vendors (HIH/HISP/Clearinghouse)
Section 3.2: Removed organization names for EHR, Document Management, and HIH System optionsSection 3.3: Removed language for Standards
Added content to the Introduction section that reference the HITECH Act
Updated 'Additional Considerations’ to enhance the flow of the section/language
Updated language on the EMDI Overview
Included assumptions for EMDI use cases
Reorganized the structured of the IG to include Pilot Participants before Use Case
EMDI Identified Standards and Implementation Specification: Included language to differentiate the standards
Direct: Updated language and included link to Direct Trust site
Connect: Included link to Connect site
Content Standard: Included language to describe its relevance to EMDI. Included additional language relevant to APIs
Messaging Data Standards: Included language that speaks to relevance of this standard for EMDI
X12: Updated language for relevancy of how it used by EMDI stakeholders
Signatures: Included additional language about the importance of signatures
Updated Implementation Standard and Security to Pre-Pilot Conditions
Removed acronym ‘CDE’ to minimize confusion
LOINC Code: Updated language for relevance to EMDI
Section 2.4.2: Content Standards: Definition of structured medical document added
Section 2.6.2: Digital Signatures
Section 3.4: Risks, Issues and Constraints
Section 4.0: Metadata elements
Section 2.1: EMDI Purpose
Section 2.1.3: How does EMDI fulfill this gap
Section 3.1: EMDI Program Assumptions
Section 3.2: Use Case Assumptions
Section 5.4: HL7 Da Vinci DME Order Use Case using FHIR